title: Gender differences in health-related quality of life of Australian chronically-ill adults: patient and physician characteristics do matter.
abstract: BACKGROUND
  The aims of this study were to explore the health-related quality of life (HRQoL) in a large sample of Australian chronically-ill patients (type 2 diabetes and/or hypertension/ischaemic heart disease), to investigate the impact of characteristics of patients and their general practitioners on their HRQoL and to examine clinically significant differences in HRQoL among males and females.
  
  
  METHODS
  This was a cross-sectional study with 193 general practitioners and 2181 of their chronically-ill patients aged 18 years or more using the standard Short Form Health Survey (SF-12) version 2. SF-12 physical component score (PCS-12) and mental component score (MCS-12) were derived using the standard US algorithm. Multilevel regression analysis (patients at level 1 and general practitioners at level 2) was applied to relate PCS-12 and MCS-12 to patient and general practitioner (GP) characteristics.
  
  
  RESULTS
  Employment was likely to have a clinically significant larger positive effect on HRQoL of males (regression coefficient (B) (PCS-12) = 7.29, P < 0.001, effect size = 1.23 and B (MCS-12) = 3.40, P < 0.01, effect size = 0.55) than that of females (B(PCS-12) = 4.05, P < 0.001, effect size = 0.78 and B (MCS-12) = 1.16, P > 0.05, effect size = 0.16). There was a clinically significant difference in HRQoL among age groups. Younger men (< 39 years) were likely to have better physical health than older men (> 59 years, B = -5.82, P < 0.05, effect size = 0.66); older women tended to have better mental health (B = 5.62, P < 0.001, effect size = 0.77) than younger women. Chronically-ill women smokers reported clinically significant (B = -3.99, P < 0.001, effect size = 0.66) poorer mental health than women who were non-smokers. Female GPs were more likely to examine female patients than male patients (33% vs. 15%, P < 0.001) and female patients attending female GPs reported better physical health (B = 1.59, P < 0.05, effect size = 0.30).
  
  
  CONCLUSIONS
  Some of the associations between patient characteristics and SF-12 physical and/or mental component scores were different for men and women. This finding underlines the importance of considering these factors in the management of chronically-ill patients in general practice. The results suggest that chronically ill women attempting to quit smoking may need more psychological support. More quantitative studies are needed to determine the association between GP gender and patient gender in relation to HRQoL.
authors.affiliation: Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia. upali.jay@unsw.edu.au
authors.forename: Upali W
authors.initials: UW
authors.lastname: Jayasinghe
authors.forename: Mark F
authors.initials: MF
authors.lastname: Harris
authors.forename: Jane
authors.initials: J
authors.lastname: Taggart
authors.forename: Bettina
authors.initials: B
authors.lastname: Christl
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Black
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000465:Algorithms; D001315:Australia; D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000628:therapy; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000592:standards*; D010821:Physicians, Family / Q000193:education / Q000523:psychology* / Q000706:statistics & numerical data; D011365:Professional Practice Location / Q000706:statistics & numerical data / Q000639:trends; D011788:Quality of Life; D012737:Sex Factors; D012959:Socioeconomic Factors